spend per person on diabetes but is five times more productive in managing diabetes than we are. dr. daniel vasella who is the chairman of novartis explains that in america, no one has incentives to make quality and cost-effective outcomes the goal, end quote. france and britain gave their health care providers incentives to focus on early defection and cost-effective treatment that make wellness the goal, not treatment. to paraphrase george washington university professor thomas j.schoenbaum, make virtue profitable and everyone becomes a saint. saving money by reforming how we deliver health care isn't just possible, it is happening. a 2008 report from the dartmouth atlas project predicted that, and i will quote -- "using the mayo clinic as a benchmark, the nation could reduce health care spending by as much as 30% for acute and chronic illnesses a benchmark based on intermountain health care -- based out in utah -- predicts a reduction of more than 40%." so we're doing it. it's happening. we just need to spread it more widely. during a 2011 senate help hearing that i chaired, g